JP2011056079A - Device for functional recovery training of hemiplegic finger - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a functional recovery training device that can encourage a patient to make his/her own effort to extend his/her hemiplegic finger. <P>SOLUTION: The training device 20 includes a slope 25 to support a patient's arm 24, a hand-placing stand 28 to support his/her hand 27, a bracket 29 extending upward from the front of the hand-placing stand 28, and a finger-bending mechanism 40 installed on the bracket 29 to push down, e.g. a forefinger 11. The finger-bending mechanism 40 applies downward external force when bending the finger 11, but does not apply the external force when extending the finger 11. Since, the extension of the finger 11 is an extension movement on his/her own, the device encourages the patient to extend his/her finger on his/her own effort and enhances the finger recovery training effects. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to a hemiplegic finger function recovery training device for recovery training of a finger of a patient who has been paralyzed with a finger of one hand.

Hemiplegia often remains after a stroke. In this hemiplegia, the function of the finger can be restored by rehabilitation. This rehabilitation is carried out by skilled doctors and therapists, but since training takes a long time and a long period of time, the physical burden on the doctors and therapists is great.
In order to eliminate this burden, conventionally, a training apparatus has been proposed (for example, refer to Patent Document 1 (FIG. 15)).

Patent document 1 is demonstrated based on the following figure.
FIG. 14 is a diagram for explaining the basic principle of the prior art. In this training apparatus 100, links 103 to 106 extend from a second support body 102 that supports a hand 101 indicated by an imaginary line. A fifth mounting portion 107 is provided at a connecting portion with 155, and a fourth mounting portion 108 is provided at the tip of the link 106.

  As described in paragraph [0078] of Patent Document 1, with the above configuration, the finger movement support mechanism for the second finger to the fifth finger can displace the affected upper limb finger in various modes.

  The bending by applying a force from the outside to the finger 109 at the fourth mounting portion 108 and the fifth mounting portion 107 is referred to as other dynamic bending. In addition, extending the finger 109 by applying an external force is referred to as other dynamic extension. On the other hand, extending the finger 109 by the patient's force without applying external force is referred to as self-stretching.

In the conventional training apparatus that alternately repeats other dynamic flexion and other dynamic extension on the finger 109, it is unclear whether or not the patient's own force is reflected. If the patient's own power is not reflected, the effect of the training is small and the training is prolonged.
Therefore, a training apparatus that can promote self-extension is desired.

JP 2008-67852 A

  An object of the present invention is to provide a training device that can promote self-stretching.

The invention according to claim 1 is a hemiplegic finger function recovery training device for recovery training of the finger of a patient whose finger of one hand is paralyzed,
This hemiplegic finger function recovery training device has a hand platform on which a hand is placed and an extension operation in which one of the fingers on the hand platform is pushed down to bend and the bent finger tries to return. Comprises a finger bending mechanism that does not hinder and a finger tapping mechanism that urges the base of the finger pushed down by the finger bending mechanism to promote the extension operation.

  The invention according to claim 2 is characterized in that the hand platform reciprocates up and down with the vicinity of the wrist of the hand as a swing fulcrum.

  In the invention according to claim 3, the finger bending mechanism extends from the first shaft provided below the table to substantially extend along the table and pivots up and down about the first axis. 1 arm, a first servo motor for turning the first arm up and down, a first torque measuring mechanism for detecting torque applied to the first arm, and a second shaft provided above the hand platform Extending to intersect the first arm, and a second arm that pivots up and down about the second axis, a second servo motor that pivots the second arm up and down, and a second arm A second torque measuring mechanism for detecting applied torque; and the second arm, which is disposed at an intersection of the first arm and the second arm, is attached to the first arm so as to be movable in the axial direction of the first arm and the second arm Movable in the axial direction of the first Control for acquiring torque information from the slider attached to the arm, the finger pushing part for pushing down the finger attached to the slider, and the first and second torque measuring mechanisms and controlling the first servo motor and the second servo motor And a portion.

In the invention which concerns on Claim 1, the finger base after a bending | flexion is hit with a finger hitting mechanism. Then, the motor nerves of the patient are stimulated, and the finger tries to return to its original state, and self-stretching is expected.
That is, according to the present invention, a training apparatus capable of promoting self-stretching is provided.

  In the invention which concerns on Claim 2, a patient's wrist is rock | fluctuated by a hand stand. The wrist dorsiflexion motion can be added to the self-stretching motion of the finger, and the effect of the recovery training can be enhanced as compared with the finger-only training.

In the invention which concerns on Claim 3, in the training apparatus which performs a patient's finger | toe a passive dynamic bending and self-extension, the mechanism which moves a patient's finger | toe, the 1st arm and the 2nd arm which cross | intersect each other, these And a finger pressing portion provided on the slider.
The first arm is driven by the first servo motor, and the second arm is driven by the second servo motor.
By controlling the output of the first servo motor and the output of the second servo motor, the slider and the finger pressing unit can be held at arbitrary positions, and can be moved on an arbitrary movement locus.

The above-mentioned movement trajectory can also be obtained by the cam mechanism, but if the movement trajectory needs to be corrected, the cam must be replaced, and correction is difficult. In this regard, according to the present invention, it is possible to cope with this by simply changing the motor output, and the movement locus can be corrected very easily.
Therefore, training of various patients can be carried out by one training apparatus, and the operating rate of the training apparatus can be increased.

It is a figure explaining the mode of training which recovers the hemiplegia finger function concerning the present invention. It is a perspective view of the hemiplegic finger function recovery training apparatus concerning the present invention. It is sectional drawing of a hemiplegia finger function recovery training apparatus. It is a figure explaining the structure of a slider. FIG. 5 is a sectional view taken along line 5-5 of FIG. It is a triangle figure for demonstrating the principle of a bending mechanism. It is a figure explaining the action | operation principle of a bending mechanism. It is an effect | action figure explaining from a finger's other dynamic bending start to the middle of bending. It is an action figure explaining self-extension from the end of other dynamic bending of a finger. It is a figure explaining the change Example of a finger hitting mechanism. It is a figure explaining the operation | movement which the finger | toe hitting mechanism of FIG. It is a figure explaining the operation | movement which the finger tapping mechanism of FIG. 10 prints up a finger. It is a perspective view of a torque measurement mechanism. It is a figure explaining the basic composition of the conventional hemiplegia finger function recovery training device.

  Embodiments of the present invention will be described below with reference to the accompanying drawings. The drawings are viewed in the direction of the reference numerals.

First, the content of training aimed by the present invention will be described with reference to FIG.
In FIG. 1 (a), the assistant applies force F1 to the index finger 11 of the patient's hand 10, and starts the bending operation of the finger as indicated by the arrow (1). At the same time, the caregiver bends the bent wrist 12 (arrow (2)).

Then, as shown in (b), the finger 11 is continuously bent by the force F2 (arrow (3)).
Further, as shown in (c), the finger 11 is continuously bent by the force F3 (arrow (4)), and the wrist 12 is bent (arrow (5)).
In (a) to (c), bending the finger 11 with the force F of the assistant is called other dynamic bending.

Next, at (d), the assistant taps the base 13 of the finger 11 as shown by the arrow (6). By tapping it, the patient's motor nerve is stimulated, and the finger 11 expands as shown in (e) (arrow (7)) and returns to (a). At this time, the assistant's fingers 15 and 16 are attached to the upper surface of the patient's finger 11, and the assistant's fingers 15 and 16 are raised following the extension operation of the finger 11.
In (d) to (e) to (a), the finger 11 expands by itself without external force. This is called self-stretching.

A preferred embodiment of a training apparatus capable of performing the other dynamic bending and self-extension described above will be described with reference to the drawings.
As shown in FIG. 2, a hemiplegic finger mechanism recovery training device 20 (hereinafter, abbreviated as “training device 20”) includes a rectangular base plate 21 and a vertical wall portion that stands vertically and parallel to the base plate 21. 22, 22, a slope portion 25 that supports the patient's arm 24 passed to the hypotenuses of these vertical wall portions 22, 22, and a patient's hand 27 supported by the swing shaft 26 passed to the vertical wall portions 22, 22. A supporting table 28, a gate-shaped or box-shaped bracket 29 extending upward from the front of the table 28, and a finger bending mechanism 40 that is attached to the bracket 29 and depresses the index finger 11, for example. .

  As shown in FIG. 3, the finger bending mechanism 40 extends substantially from the first shaft 41 provided below the hand platform 28 along the hand platform 28, and pivots up and down around the first shaft 41. A first arm 42, a first servo motor 44 that is supported by an L-shaped sub-bracket 43 extending downward from the hand rest 28 and pivots the first arm 42 up and down, and a portal or box-shaped bracket 29 A second arm 46 extending from the second shaft 45 provided to the first arm 42 so as to intersect the first arm 42 and pivoting up and down about the second shaft 45, and a second arm 46 provided on the bracket 29. The second servomotor 47 that pivots up and down is disposed at the intersection 48 of the first arm 42 and the second arm 46, and is attached to the first arm movably in the axial direction of the first arm 42 and the second arm Free to move in 46 axial directions A slider 49 attached to the second arm 46, a finger pressing part 51 attached to the slider 49 for pressing down a finger (FIG. 2, reference numeral 11), a first encoder 52 for monitoring the rotation angle of the first servo motor 44, and It comprises a control unit 54 that acquires rotation angle information from a second encoder 53 that monitors the rotation angle of the second servo motor 47 and controls the first servo motor 44 and the second servo motor 47.

  Note that a special first torque measurement mechanism 90 that can measure the drive torque (Term1) of the first arm 42 is provided at the base of the first arm 42, and torque information is sent to the control unit 54. Similarly, a special second torque measurement mechanism 95 that can measure the drive torque (Term2) of the second arm 46 is provided at the base of the second arm 46, and torque information is sent to the control unit 54.

  Torque is obtained by measuring strain with a strain gauge and converting this strain. It can be considered that a strain gauge for this purpose is directly attached to the first arm 42. However, when the distortion generated in the first arm 42 is very small, the influence of the error becomes remarkable, and the reliability of measurement is lowered. As a countermeasure, the present embodiment employs special torque measuring mechanisms 90 and 95 that can expand (amplify) the distortion.

First, the first torque measurement mechanism 90 will be described with reference to FIG.
In FIG. 13, a support block 91 is rotatably attached to the first shaft 41, and the first arm 42 is fixed to the support block 91. In this state, the driving torque from the first shaft 41 is not transmitted to the first arm 42.
Therefore, the driving plate 92 is fixed to the first shaft 41, a constricted portion 93 is provided in the middle of the driving plate 92, and a strain gauge 94 is attached (or built in) to the constricted portion 93, and the tip of the driving plate 92 is provided. Is connected to the first arm 42.

According to the first torque measuring mechanism 90 having such a structure, the drive torque from the first shaft 41 is transmitted to the first arm 42 via the drive plate 92. At this time, the constricted portion 93 bends more than other portions, so that the distortion is expanded.
Since the second torque measurement mechanism 95 attached to the second arm 46 has the same structure, the description thereof is omitted.

  Returning to FIG. 3, the third servo motor 55 provided on the hand platform 28, the third encoder 56 for monitoring the rotation angle of the third servo motor 55, and the punch turned up and down by the third servo motor 55 The training apparatus 20 includes a finger striking mechanism 58 for striking the base of the patient's finger.

  Preferably, it comprises a fourth servo motor 59 provided on the vertical wall portion 22 for swinging (rotating) the swing shaft 26 and a fourth encoder 61 for monitoring the rotation angle of the fourth servo motor 59. The training apparatus 20 includes a wrist bending / stretching mechanism 62 that reciprocates 28 up and down.

  The control unit 54 acquires the rotation angle information from the third and fourth encoders 56 and 61 in addition to the first and second encoders 52 and 53, and in addition to the first and second servomotors 47, • The fourth servomotors 55 and 59 are also controlled comprehensively.

Next, the structure of the slider 49 disposed at the intersection 48 between the first arm 42 and the second arm 46 will be described.
As shown in FIG. 4, the slider 49 includes a slider main body 64 that extends vertically, a first roller 65 that is rotatably attached to the upper portion of the slider main body 64 and that freely rotates along the upper surface of the first arm 42, A second roller 66 rotatably attached to the lower portion of the slider body 64 and freely rotating along the lower surface of the first arm 42, a protrusion 67 extending from the slider body 64 along the first arm 42, and the protrusion A third roller 68 that is rotatably mounted on the portion 67 and freely rotates along the side surface (outer surface) of the first arm 42; and a side surface of the first arm 42 that is rotatably mounted below the protrusion 67 (see FIG. And a fourth roller 69 that freely rotates along the outer surface.

FIG. 5 is a cross-sectional view taken along line 5-5 in FIG. 3, and two sliders 49 and 49 are connected by a single support shaft 71. The support shaft 71 passes through the first arm 42 and the second arm 46, and is provided with a finger pressing portion 51 having a cylindrical shape at the center and a surface fastener 72 affixed on the surface thereof. It moves along the second arm 46 via the rollers 73 and 73.
That is, the support shaft 71 moves along the first arm 42 and the second arm 46.

  A hook-and-loop fastener 74 is wound around the finger 11, and the hook-and-loop fastener 74 is coupled to a hook-and-loop fastener 72 on the support shaft 71 side. Thereafter, the finger 11 moves together without leaving the finger pressing portion 51.

  In FIG. 3, when the center of the first axis 41 is A, the center of the second axis 45 is O, and the intersection 48 is B, the triangle OAB shown in FIG. 6 can be drawn. The side OA has a fixed length, and the other sides AB and OB have variable lengths.

In the triangle OAB shown in FIG. 6, the axis passing through the side OA is the x axis, the axis passing through the point O (origin) and perpendicular to the x axis is the y axis, the length of the side 0A is L (constant value), and the length of the side OB Let L1 (variation value), angle O be θ1, and angle (outer angle) A be θ2.
From angle O + angle B = angle A, angle B = angle A−angle O = θ 2 −θ 1, and angle B becomes (θ 2 −θ 1). The inner angle A is (2π−θ2).

If the coordinates of the point B are (x, y), x = L1 · cos θ1 and y = L1 · sin θ1.
From the sine theorem, L / sin (θ2−θ1) = L1 / sin (2π−θ2).
Here, sin (2π−θ2) = sin θ2. When L / sin (θ2−θ1) = L1 / sinθ2 is arranged with respect to L1, L1 = L · sin θ2 / sin (θ2−θ1) is obtained. This L1 is substituted into x = L1 · cos θ1 and y = L1 · sin θ1.
x = L · cos θ1 · sin θ2 / sin (θ2−θ1)
y = L · sin θ1 · sin θ2 / sin (θ2−θ1)

  The point B, that is, the position of the finger pressing portion is uniquely determined by θ1 and θ2, and the finger pressing portion can be controlled on a two-dimensional plane. The relational expression of the speed (hand speed) and the force (hand external force) relating to the point B can be expressed as follows.

The locus of point B can be described by another simple method.
In FIG. 7A, it is assumed that the first arm 42 is kept in a non-rotating state and the second arm 46 is rotated clockwise by the driving torque Term2. Then, the point B moves along the first arm 42 as indicated by an arrow (11).

  Further, in (b), it is assumed that the second arm 46 is maintained in a non-rotating state and the first arm 42 is rotated clockwise by the drive torque Term1. Then, the point B moves along the second arm 46 as indicated by an arrow (12).

In (c), when the first arm 42 is rotated clockwise by the driving torque Term1, and the second arm 46 is rotated clockwise by the driving torque Term2, the point B is as shown by the arrow (13). Moving. This movement trajectory can be arbitrarily drawn by changing Term2 and Term1.
Therefore, in FIG. 3, the position, moving direction, speed, and force of the finger pressing unit 51 can be arbitrarily set by changing the driving torque, the rotating direction, the rotating speed, and the like of the first servo motor 44 and the second servo motor 47. Can be controlled.

Next, the operation of the training apparatus 10 described above will be described.
As shown in FIG. 8A, the hand 27 is placed on the hand rest 28 and the finger 11 around which the surface fastener 74 is wound is inserted under the finger pressing portion 51. And a training apparatus (FIG. 2, code | symbol 20) is started. Then, the finger pressing part 51 starts to descend as shown by an arrow. The angle between the table 28 and the slope 25 is α.

Subsequently, as shown in (b), the table 28 is rotated counterclockwise in the figure (arrow (11)), and the angle between the table 28 and the slope 25 is increased to β (angle α < Angle β). Thus, the wrist 12 is bent back.
In parallel with this dorsiflexion, the finger 11 continues to descend (arrow (12)).

In FIG. 9A, the other dynamic bending of the finger 11 is completed, and the base 13 of the finger 11 is hit with the punch 57 in this state (arrow (13)). The punch 57 is returned.
At the same time, the finger pressing portion 51 is moved counterclockwise in the figure at a speed at which the finger 11 returns (arrow (14)). The finger pressing unit 51 does not apply an external force to the finger 11 but attaches it, and does not hinder the self-extension of the finger 11. At the same time, the hand platform 28 is turned counterclockwise (arrow (15)). Thus, the wrist 12 is bent.
As shown in FIG. 8B, the finger 11 extends by itself (arrow (16)), and the process returns to FIG.

  As described above, the other dynamic bending / extension and self-extension of the finger 11 are repeated. In addition, the bending and dorsiflexion of the wrist 12 are repeated. Since the training equivalent to the training described in FIG. 1 is performed by the training device 10 of the present invention, the burden on doctors and therapists who have been engaged in training can be greatly reduced.

Next, an example of changing the finger tapping mechanism will be described.
As shown in FIG. 10, the changed finger tapping mechanism 80 includes a crank-shaped (or Z-shaped) bracket 81, a third servo motor 55 attached to the lower portion of the crank-shaped bracket 81, and the third servo motor. The rectangular piece 83 fixed to the motor shaft 82 of 55, the punch 57 having the groove 84 for movably storing the rectangular piece 83, and the rectangular piece 83 fitted in the groove 84 are moved toward the tip of the punch 57. It comprises a compression spring 85 for pushing, a free roller 86 provided at the rear end of the punch 57, and a cam plate 87 fixed to the upper part of the crank-shaped bracket 81 for guiding the free roller 86.

  Preferably, a protrusion 89 made of a soft material is attached to the lower surface of the tip of the punch 57. The protrusion 89 has a softness and a shape imitating the fingertip of the assistant.

  The straight portion of the cam plate 87 forms an angle γ (γ is a positive number not including 0) with the longitudinal axis 88 of the punch 57. The position of the motor shaft 82 and the position of the cam plate 87 are unchanged, but γ changes because the punch 57 moves. This point will be described below.

  In FIG. 11A, the position (position) of the tip of the punch 57 is Pa. From this state, the motor shaft 82 is rotated clockwise in the figure. Then, the punch 57 tries to rotate clockwise in the figure.

  As a result, as shown in (b), the free roller 86 starts to rotate along the cam plate 87 (arrow (21)). Then, the rectangular piece 83 supported by the motor shaft 82 rotates slightly clockwise, and the punch 57 moves (advances) to the lower right in the figure in order to allow the movement of the punch 57. The compression spring 85 contracts. The position of the tip of the punch 57 in the figure is Pb.

Furthermore, as shown in (c), the free roller 86 continues to rotate along the cam plate 87 (arrow (22)). The punch 57 further moves to the lower right in the figure, and the projection 89 strikes the second joint of the finger 11. The compression spring 85 further shrinks. The position of the tip of the punch 57 in the figure is Pc.
That is, by rotating the motor shaft 82 in the forward direction, the tip of the punch 57 moves in the order of Pa → Pb → Pc and strikes the second joint of the finger 11.

When struck, the motor shaft 82 is quickly reversed, that is, rotated counterclockwise in the figure. Then, the tip of the punch 57 returns as Pc → Pb → Pa. This operation will be described in detail.
As shown in FIG. 12A, the finger 11 returns as shown by the arrow (23) by self-extension. The tip of the punch 57 returns to Pb so as to follow this operation. At this time, the punch 57 not only rises, but also retreats as indicated by the arrow (24), and slides up the upper surface of the finger 11. Then, the self-extension of the finger 11 is further promoted.
Subsequently, as shown in (b), the finger 11 returns as shown by the arrow (25) by self-extension. The tip of the punch 57 returns to Pa so as to follow the movement of the finger 11.

  That is, in FIG. 11C to FIG. 12B, it can be expected that the punch 57 moving as Pa → Pb → Pc slides up the upper surface of the finger 11 and promotes the self-extension of the finger 11.

  In the first and second aspects, the finger bending mechanism is not limited to the mechanism described in the embodiment including the first arm, the second arm, and the slider, but the finger pressing portion is reciprocated on a desired locus by a cam mechanism. It may be moved. However, in the case of a cam mechanism, it is necessary to replace the cam plate when the shape of the training object changes greatly, such as when the length of a patient's finger changes. In this regard, if the mechanism is composed of the first arm, the second arm, and the slider, the locus of the finger pressing portion can be arbitrarily changed by controlling the torque applied to the first arm and the torque applied to the second arm. Therefore, versatility is high.

  In addition, in the first aspect, the hand platform may be reciprocally movable up and down, or may not be reciprocally movable. If it does so, the structure of a training apparatus will become simple and it can manufacture at low cost.

  The present invention is suitable for a training apparatus used for function recovery training for hemiplegic fingers.

  10, 27 ... Patient's hand, 11 ... Finger (index finger), 12 ... Wrist, 13 ... Base of finger, 15, 16 ... Helper's finger, 20 ... Hemiplegic finger mechanism recovery training device, 28 ... Hand rest, 40 ... finger bending function, 41 ... first axis, 42 ... first arm, 44 ... first servo motor, 45 ... second axis, 26 ... second arm, 27 ... second servo motor, 28 ... intersection, 29 ... Slider, 51... Finger pressing unit, 54... Control unit, 58 and 80 .. finger tapping mechanism, 62... Wrist bending mechanism, 90.

Claims (3)

A hemiplegic finger function recovery training device for recovery training of the finger of a patient whose one hand is paralyzed,
This hemiplegic finger function recovery training device
A platform for placing hands,
A finger bending mechanism that pushes down and bends one of the fingers of the hand placed on the table and does not hinder the stretching operation in which the bent finger tries to return;
A hemiplegic finger function recovery training device, comprising: a finger tapping mechanism that urges the base of the finger pushed down by the finger bending mechanism to promote the extension operation.   The hemiplegic finger function recovery training device according to claim 1, wherein the hand table reciprocates up and down with the vicinity of the wrist of the hand as a swing fulcrum. The finger bending mechanism is
A first arm extending substantially along the table from a first axis provided below the table, and pivoting up and down about the first axis;
A first servo motor that swings the first arm up and down;
A first torque measuring mechanism for detecting torque applied to the first arm;
A second arm that extends from a second shaft provided above the hand platform so as to intersect the first arm and pivots up and down about the second shaft;
A second servo motor that swings the second arm up and down;
A second torque measuring mechanism for detecting torque applied to the second arm;
It is disposed at the intersection of the first arm and the second arm, is attached to the first arm so as to be movable in the axial direction of the first arm, and is movable to the second arm so as to be movable in the axial direction of the second arm. A slider mounted,
A finger pressing part that is attached to the slider and depresses the finger;
3. A hemiplegia according to claim 1, further comprising a control unit that acquires torque information from the first and second torque measuring mechanisms and controls the first servo motor and the second servo motor. Finger function recovery training device.

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